Moral distress among critical care nurses before and during the COVID-19 pandemic: A systematic review

Nursing Ethics, Год журнала: 2023, Номер 31(4), С. 613 - 634

Опубликована: Дек. 20, 2023

Moral distress has emerged as a significant concern for critical care nurses, particularly due to the complex and demanding provided critically ill patients in units. The ongoing COVID-19 pandemic introduced new ethical challenges changes clinical practice, further exacerbating experience of moral among these nurses. This systematic review compares factors influencing nurses before during gain comprehensive understanding impact on distress. For this review, PubMed, Scopus, ProQuest, Web Science, medRxiv, bioRxiv, Embase, Google Scholar were all utilized search. search covered articles published from 2012 December 2022, encompassing 10-year timeframe capture relevant research In total, 52 included review. findings indicate that personal, caring-related, organizational can influence nurses' Before pandemic, including futile end-of-life care, conflicts with physicians, nurse performance authority, poor teamwork, decision-making regarding treatment processes patient limited human resources equipment, medical errors, restraints, age work affect Similarly, contributing include fear contracting spreading COVID-19, about processes, being female. study revealed approximately similar both periods. Futile issues primary causes Implementing prevention strategies reducing underlying could decrease major issue improve quality care.

Язык: Английский

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Unveiling nurses’ end-of-life care experiences: Moral distress and impacts

Nursing Ethics, Год журнала: 2024, Номер 31(8), С. 1600 - 1615

Опубликована: Апрель 16, 2024

Background Nurses providing care to patients with end-of-life or terminal illnesses often encounter ethically challenging situations leading moral distress. However, existing quantitative studies have examined distress using instruments that address general clinical rather than those specific care. Furthermore, qualitative been limited participants from a single unit experiencing distress-induced circumstances. A comprehensive and integrated understanding of the overarching process is vital discern unique circumstances surrounding its consequential impacts. Research objectives To explore experiences nurses who are frequently involved in caring for apply it two theories: model ecological model. design descriptive approach was employed. Participants research context Seven focus group interviews involving 30 were performed. The subsequent transcriptions underwent rigorous content analysis. Ethical considerations We obtained Institutional Review Board approval university. Focus conducted agreed participate signed consent form. Findings distress-inducing factors nurses’ perceived impact identified categorized based on theories models. total 15 categories subcategories across following 4 domains derived: (1) intrapersonal, (2) interpersonal, (3) organizational, (4) structural factors. Conclusions End-of-life-specific induced among nurses, both negative positive impacts identified. Effective organizational policy support essential manage conflicts, form healthy culture, provide training, prevent unnecessary expenses due consequences

Язык: Английский

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Differences in the depression and burnout networks between doctors and nurses: evidence from a network analysis

BMC Public Health, Год журнала: 2024, Номер 24(1)

Опубликована: Июнь 22, 2024

Abstract Background Previous studies have demonstrated a strong association between depression and job burnout among healthcare professionals, but the results been inconsistent, there is lack of in-depth exploration such relationship different professions. The present study aims to investigate interrelationships Chinese professionals whether are differences in networks these symptoms doctors nurses. Methods Maslach Burnout Inventory-General Survey 2-item Patient Health Questionnaire were employed assess 3,684 professionals. translation has refined ensure accuracy academic suitability. Subsequently, network analysis was conducted on 2,244 participants with higher level identify core explore associations depression. Results showed interest pleasure things being exhausted from work , excessive tiredness facing tendency collapse at passion for than before as well notable difference nurses doctors. Conclusions depression-burnout structures differ nurses, highlighting need targeted intervention measures both groups.

Язык: Английский

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Sources of moral distress in nursing professionals: A scoping review

Nursing Ethics, Год журнала: 2025, Номер unknown

Опубликована: Янв. 11, 2025

This article presents a scoping review aimed at mapping the main sources of moral distress among nursing professionals. The was conducted according to Arksey and O’Malley methodology, using SPIDER framework guide systematic search in BVS, PubMed, PsycArticles, Scielo, Scopus databases. Initially, 2320 publications were identified. After application inclusion exclusion criteria, 83 studies selected for analysis terms their methodological characteristics, objectives, practice contexts, various facilitated grouping these into specific situations, reflecting challenges experienced by nurses under different settings. augments knowledge causes nursing, highlighting impact this phenomenon on physical mental health professionals, as well quality care provided.

Язык: Английский

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Prevalence of the symptoms of post-traumatic stress disorder (PTSD) and burnout syndrome (BOS) among intensive care unit (ICU) healthcare workers during the COVID-19 pandemic

Psychology Health & Medicine, Год журнала: 2025, Номер unknown, С. 1 - 12

Опубликована: Янв. 22, 2025

Pandemic COronaVIrus Disease-19 (COVID-19) was a traumatic event that had significant impact on the mental health of healthcare workers (HCWs), especially intensive care units (ICUs). Months exposure and threat death can lead to post-traumatic stress disorder (PTSD), high physical emotional strain burnout syndrome (BOS). The purpose this study assess prevalence PTSD BOS among ICU HCWs during COVID-19 pandemic. A case-control conducted in 2022 using diagnostic survey method with 148 hCWs from two units: temporary unit (tICU, n = 93) general (gICU, 55) Cracow, Poland. Impact Events Scale (IES-R), Oldenburg Burnout Inventory (OLBI) proprietary questionnaire were used. results obtained indicate 46.62% (69) pronounced symptoms. In tICU HCWs, 47.31% (44) severe symptoms PTSD, gICU 45.45% (25) affected. reported highest score Hyperarousal domain (x 1.52; SD 0.87), while higher scores Avoidance (xx 1.45 0.81). presented moderate levels job domains exhaustion (50.68%; 75) lack commitment (64.86%; 96). It shown work significantly more frequent group than (p 0.022). greater level or withdrawal, severity each symptom. Activity responsibility fatigue found be most stressful workplace. co-occurred BOS. is necessary provide employees targeted psychological support dealing post-pandemic crisis retention nurses profession.

Язык: Английский

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A Theoretical Model of Clinical Nurses’ Intentions to Stay During Disasters: A Structural Equation Modeling Approach

Journal of Nursing Management, Год журнала: 2025, Номер 2025(1)

Опубликована: Янв. 1, 2025

Background: With the increasing frequency and severity of disasters, retaining skilled nurses is essential for sustaining healthcare systems in times crisis. Given that behavior largely influenced by intention, a predictive model nurses’ intent to stay (ITS) needed. Aim: This study aimed develop validate comprehensive structural explaining clinical ITS during disasters. addresses critical need understand enhance nurse retention crises. Methods: In this cross‐sectional study, 549 who worked COVID‐19 pandemic participated. The data were collected through web‐based self‐report survey from March 5 15, 2024. Factor analysis, fit confirmation, path significance analyzed using SPSS/WIN 23.0 AMOS 28.0. A two‐step approach was employed hypothetical model. Results: Group cohesion significantly impacted organizational commitment, empowerment, job satisfaction. Adequate staffing resources crucial influencing moral distress commitment. Both satisfaction commitment directly affected ITS, with group exerting an indirect effect. Path analysis demonstrated adequate notably while adaptive leadership, staffing, disaster nursing competency explained 71.4% variance intention Conclusion: highlights strongest predictor remain Implications Nursing and/or Health Policy: To ensure stable workforce situations, it foster Strategies should focus on enhancing cohesion, providing resources, supporting among nurses.

Язык: Английский

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Moral distress: A structural problem with individual solutions

Journal of Health Services Research & Policy, Год журнала: 2025, Номер unknown

Опубликована: Янв. 24, 2025

Язык: Английский

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An Exploratory Model of How Ethical Indicators Predict Health Professional Burnout

Research in Nursing & Health, Год журнала: 2025, Номер unknown

Опубликована: Янв. 28, 2025

ABSTRACT The objectives of this study were to characterize burnout in five different health professions (i.e., pharmacists, nurses, occupational therapists, psychologists, and mental counselors) as well determine if moral distress, ethical stress, and/or climate predictive job satisfaction. Cross‐sectional survey data collected the USA using validated measures from a sample 291 early 2022 (COVID‐19 Omicron wave). average age participants was 51 years (s.d. = 12.59) most identified female (78%), White/Caucasian (82%), married/in domestic partnership (72%), without dependents (57%), had > 20 experience (53%). Results demonstrated that two three dimensions emotional exhaustion depersonalization) reached clinically significant levels among but not psychologists or counselors. In testing an exploratory structural equation model, ethics contributed significantly satisfaction all professionals (CFI 0.905; SRMR 0.056; Gamma hat scaled 0.931). These findings support theoretical framework for explaining associations between indicators Future research should explore with less differences organizational environment, autonomy, independence clinical work, professional identity. Exploration into socialization, such strategies learned part training development, may be warranted identify factors buffer mitigate risk.

Язык: Английский

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Burnout among intensivists and critical care fellows in South Korea: Current status and associated factors

PLoS ONE, Год журнала: 2025, Номер 20(2), С. e0318495 - e0318495

Опубликована: Фев. 4, 2025

Burnout among critical care physicians is an important issue that affects patient and staff well-being. This study, conducted by the Korean Society of Critical Care Medicine, aimed to investigate prevalence associated factors burnout intensivists fellows in South Korea. From May July 2019, a cross-sectional survey was 51 hospitals 79 intensive units offering subspecialty training medicine. Invitations were sent email text, responses collected using NownSurvey Google Forms. Of 502 invited participants, 253 responded (response rate: 50.4%). Significant contributing included being intensivist position (assistant professor/fellow) (odds ratio [OR], 3.916; 95% confidence interval [CI], 1.485–10.327; p = 0.006), working medical ICU (OR, 4.557; CI, 1.745–11.900; 0.002), number stay-home night calls per month 1.070; 1.005–1.139; 0.034), recent conflicts with colleagues 5.344; 1.140–25.051; 0.033). Similar found influence severe levels burnout. nationwide study indicates significant proportion Korea experience Strategies reduce overtime workplace conflict are imperative these protect their mental health. Future research should explore targeted interventions for specific factors.

Язык: Английский

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Evolution of burnout syndrome in Spanish healthcare professionals during and after the COVID-19 pandemic: psychosocial variables involved

Frontiers in Medicine, Год журнала: 2025, Номер 12

Опубликована: Фев. 7, 2025

Evidence shows that throughout the COVID-19 pandemic, healthcare workers have experienced high levels of burnout. The preceding literature also points to need consider three elements burnout independently, as they appear different evolutionary trends and possibly buffering amplifying variables, although these aspects hardly been explored. aim present investigation is precisely shed light on latter issues. It a prospective study, carried out in 256 Spain during time relation pandemic: (1) (T1) between 5 May 21 June 2020 (final phase state alarm declared 14 March), (2) (T2) 6 months after end (January-April 2021), (3) (T3) 1 year this second evaluation (April-July 2022). components syndrome (emotional exhaustion, depersonalization self-fulfillment) were assessed at third points. Together with sociodemographic occupational data (age, gender, professional category, years experience, hours work), anxiety, depression, stress, family support, friends' self-efficacy first point. At point, cognitive fusion resilience assessed. optimism hopelessness results show significant decreases (p < 0.001). However, when observing evolution each dimensions, it can be seen emotional exhaustion has significantly decreased 0.001), while an increase 0.001) decrease self-fulfillment (all p are observed. repeated measures General Linear Models, controlling for effect covariates associated depression T1 = 0.031), T2 0.039). 0.042). Finally, self- fulfillment T3 0.043) 0.019). highlight attend differentiated manner. Our indicate that, overall tend decrease, actually decreases, but decreases. In addition, point personality factors involved dimensions. While seems more affected by symptomatology (i.e., depression) onset inability handle intrusive thoughts fusion), related long-term cognitive-emotional variables such hopelessness. found important practical implications prevention implicated syndrome. Although further research needed, shown one dimensions short term intervention programs aimed reducing anxiety times acute stress (onset pandemic), including thought management, seem fundamental. Depersonalization do not respond same pattern. They chronification poor management case their appearance, given hopelessness), therapies focused meaning existence, Acceptance Commitment Therapy, could useful.

Язык: Английский

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